1619911468 NPI number — ADVOCATE HEALTH AND HOSPITALS CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619911468 NPI number — ADVOCATE HEALTH AND HOSPITALS CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVOCATE HEALTH AND HOSPITALS CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619911468
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3825 HIGHLAND AVE
Provider Second Line Business Mailing Address:
SUITE 5F
Provider Business Mailing Address City Name:
DOWNERS GROVE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60515-1552
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-971-5878
Provider Business Mailing Address Fax Number:
630-275-5868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3825 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
SUITE 5F
Provider Business Practice Location Address City Name:
DOWNERS GROVE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60515-1552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-275-1283
Provider Business Practice Location Address Fax Number:
630-275-5868
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHIGANOS
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST
Authorized Official Telephone Number:
630-275-1283

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  058007247 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 362169E11 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1444354 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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